| NPI | 1780093708 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BILL W DOUGLAS Vice President And CFO 815-935-7256 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) (Licence: IL 0002014) |
| Additional Taxonomies | 282N00000X General Acute Care Hospital (Licence: IL 0002014) |
| Enumeration Date | 2014-08-04 |
| Last Update Date | 2016-04-06 |